Healthcare Provider Details

I. General information

NPI: 1508998329
Provider Name (Legal Business Name): GREGG A SENTENN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 05/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 E BIRCH ST STE. 100
BREA CA
92821-6264
US

IV. Provider business mailing address

1626 WARDMAN DR
BREA CA
92821-1849
US

V. Phone/Fax

Practice location:
  • Phone: 714-528-9335
  • Fax: 714-528-9630
Mailing address:
  • Phone: 714-990-2006
  • Fax: 714-990-9201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG27452
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG27452
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: